An economic evaluation of a self-management programme for patients with COPD

Introduction: Chronic Obstructive Pulmonary Disease (COPD) places a heavy burden on healthcare systems, patients and society. The Self-Management Programme of Activity, Coping and Education (SPACE) has been developed to support people with COPD to minimise symptoms, provoke health-enhancing behaviour change and enhance emotional well-being. Aim: To undertake a cost-utility analysis of SPACE FOR COPD vs usual care at six months. Methods: The analysis was conducted alongside a randomised controlled trial in 184 patients with COPD in primary care [1]. Information was obtained from three data sources (hospital, GP and patient) and triangulated to give the most likely, overall healthcare resource use. Costs were estimated from the National Health Service and Personal Social Services perspective and EuroQol-5D instrument was used at baseline and six months. Results: The intervention showed to have a statistically significant benefit to patients9 health gain (0.1 Quality Adjusted Life Years), compared to usual care at a cost increase of £27.18 per patient (95% CI; -£122.59 to £68.25). The results suggest that the SPACE FOR COPD costs around £280.00 more per additional QALY gained compared with the usual care control. There is a 97% chance that the intervention is cost-effective at a threshold of £20,000 per QALY. Conclusion: SPACE FOR COPD resulted in significant health related quality of life gains during a six-month period compared to usual care, at a slight cost increase of £27.18 per patient and is highly likely to be cost-effective at the £20, 000 threshold. Mitchell KE et al. A self-management programme for COPD: a randomised controlled trial. Eur Respir J 2014; 44: 1538-1547.